A birth control implant is a hormonal method of birth control that a medical professional inserts under the skin in the upper arm. It prevents ovulation by releasing progestogen. It is highly effective for up to 3 years and easy to insert and remove.

According to the Centers for Disease Control and Prevention (CDC), 10.3% of females aged 15–49 in the United States use long acting reversible contraception, such as an intrauterine device or an implant.

In this article, we look at how the birth control implant works, its benefits and side effects, and how a person can get one.

A woman consults with her doctor about a birth control implant.Share on Pinterest
Birth control implants release progestogen to stop ovulation from occurring.

A birth control implant (also known by its brand name, Nexplanon) is a long lasting type of hormonal contraception, also called long acting reversible contraception (LARC). It is a very small, thin, and flexible rod that a healthcare professional fits under the skin in the upper arm.

It is effective for up to 3 years, depending on the brand that a person chooses.

The implant can be 99% effective, or possibly even more. According to the CDC, it has a failure rate of 0.1%.

Planned Parenthood note that if a person does not get the implant during the first 5 days of their period, they need to use an alternative form of birth control, such as condoms, for 7 days after its insertion.

Drug interactions

Some medications can make the implant less effective as a contraceptive.

Some medications and herbal products contain certain enzymes that decrease the plasma concentrations of hormonal contraceptives, reducing their effectiveness.

These include:

  • efavirenz
  • barbiturates
  • phenytoin
  • bosentan
  • carbamazepine
  • felbamate
  • oxcarbazepine
  • griseofulvin
  • topiramate
  • rifampicin
  • rufinamide
  • aprepitant
  • St. John’s wort

Other medications and herbal products can increase the plasma concentrations of hormonal contraceptives.

These include:

  • itraconazole
  • fluconazole
  • voriconazole
  • grapefruit juice
  • ketoconazole

Other medications that can affect the effectiveness of hormonal contraceptives include those for the treatment of HIV and hepatitis C.

A person should always speak to a doctor about how their existing medications can affect the birth control implant.

Birth control implants release a hormone called progestogen. This hormone helps the body get ready for pregnancy and stops ovulation. Ovulation is the process in which eggs leave the ovaries for sperm to fertilize them in the womb.

As part of a contraceptive implant, progestogen prevents pregnancy in two ways. Firstly, it thickens the mucus on the cervix, which blocks the sperm and stops it from reaching and fertilizing an egg. Secondly, it prevents ovulation, so the ovaries do not release eggs.

If the sperm is unable to meet an egg, or if an egg does not leave the ovaries, a pregnancy cannot occur.

According to the United Kingdom’s National Health Service (NHS), the implant also thins the lining of the womb, so fertilized eggs are less likely to implant into the womb lining.

As with any type of birth control, there are several benefits and drawbacks to consider.

Advantages:

  • It is 99% effective.
  • It lasts for 3 years.
  • A person does not have to remember to take an oral pill every day at the same time, as with contraceptive pills.
  • It is suitable for those who are unable to use birth control that uses estrogen, such as the combined contraceptive pill, vaginal ring, or contraceptive patch.
  • A healthcare professional can easily remove the implant if side effects occur or if a person chooses not to continue using it for other reasons.
  • If a person wants to become pregnant, they can start trying as soon as the implant is out.
  • The implant is safe to use while breastfeeding.
  • It can reduce heavy or painful periods.

Disadvantages:

  • It will not protect a person against sexually transmitted infections (STIs) or HIV.
  • Fitting and removing the implant both require a person to visit a doctor’s office to undergo the procedure.
  • A person may experience side effects during the first few months.
  • According to the NHS, the implant may cause a person to develop acne or make existing acne worse.
  • Fitting and removing the implant may incur costs.

The most common side effect of the implant is a change in menstruation.

Periods can become lighter, heavier, longer, or irregular. They can also stop altogether.

Other less common side effects can include:

The birth control implant has some associated risks.

After insertion, a person may develop an infection at the insertion site, although this is rare. Anyone who suspects an infection should see a doctor

People should also see a doctor if:

  • the initial tenderness and bruising from fitting the implant does not go down
  • the implant feels as though it has changed shape
  • they can no longer feel where the implant is in the arm
  • they become pregnant while using the implant

Getting an implant fitted is a quick procedure.

A doctor will give the person a shot of local anesthetic to numb the area. They will then fit the implant underneath the person’s skin, which will only take a few minutes.

Stitches are not necessary. However, a person may experience some bruising, tenderness, or swelling.

Removing a birth control implant is similar to having one fitted.

A doctor will use a local anesthetic to numb the area. They will then make a small cut and gently remove the implant.

A person can get a replacement implant at this point, if they wish.

A healthcare professional needs to fit a birth control implant.

A person can visit a gynecologist, sexual health clinic, or family planning center for the insertion or removal of an implant.

The cost of getting an implant can vary.

The insertion procedure can cost up to $1,300, but health insurance may cover the procedure.

The removal of the implant can cost from $0–300.

If a person does not have health insurance, some state programs may help pay for a type of birth control.

According to the Office on Women’s Health, most insurance plans cover prescription birth control. They recommend that if a person has insurance, they check with their provider to ensure that their coverage includes birth control.

If a person does not have health insurance, they can check with family planning clinics to find birth control methods that are free or low cost. A person can find their local clinics using this tool.

If a person has Medicaid, this covers birth control. As packages can vary among states, a person should also check here to ensure that their Medicaid package covers getting the implant.

Not all types of birth control are safe and effective for everyone.

An implant may not be suitable for a person who:

  • thinks that they may be pregnant
  • takes medication that may affect how well the implant works
  • has unexplained bleeding or spotting between periods
  • experiences bleeding after sex
  • has breast cancer or has had breast cancer in the past
  • has a history of heart disease or stroke
  • has an arterial disease
  • has liver disease

These individuals should speak to a healthcare provider to determine whether a birth control implant will be right for them.

Learn more about the other available forms of contraception.

The birth control implant is a highly effective form of contraception that is easy to fit and remove and is long lasting.

Using a birth control implant does come with a few risks, such as infection and changes to the menstrual cycle, and it does not protect against STIs or HIV.

Most healthcare facilities and providers will be able to fit and remove birth control implants.